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<p>Neuroendocrine prostate carcinoma (NEPC) is an aggressive variant of prostate cancer characterized by a&#xa0;high proliferation rate, expression of neuroendocrine markers in tissue and serum, androgen-independent tumor growth, and a&#xa0;metastatic pattern that is unusual for prostate cancer. In &lt; 1% of cases, NEPC is already present at diagnosis; most NEPC develop during the course of treatment as a&#xa0;result of a&#xa0;transdifferentiation process. This multifactorial process is determined by various genetic and epigenetic alterations. Escalating treatment to target the androgen receptor signal transduction pathway appears to play a&#xa0;key role. To date, there is no generally recognized treatment standard. In first-line therapy, platinum-based chemotherapy is usually used in combination with etoposide or possibly a&#xa0;taxane. Immunotherapeutic approaches and targeted treatment strategies are currently undergoing clinical development. Due to the still limited evidence, patients should be included in clinical trials and recorded in registries.</p>

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Neuroendokrines Prostatakarzinom – verstehen, diagnostizieren, therapieren

  • 期刊论文

  • 发表日期：

    2025年2月26日

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  • Gunhild von Amsberg,
  • David Dum,
  • Markus Sauer,
  • Derya Tilki,
  • Moritz Kaune

摘要

Neuroendocrine prostate carcinoma (NEPC) is an aggressive variant of prostate cancer characterized by a high proliferation rate, expression of neuroendocrine markers in tissue and serum, androgen-independent tumor growth, and a metastatic pattern that is unusual for prostate cancer. In < 1% of cases, NEPC is already present at diagnosis; most NEPC develop during the course of treatment as a result of a transdifferentiation process. This multifactorial process is determined by various genetic and epigenetic alterations. Escalating treatment to target the androgen receptor signal transduction pathway appears to play a key role. To date, there is no generally recognized treatment standard. In first-line therapy, platinum-based chemotherapy is usually used in combination with etoposide or possibly a taxane. Immunotherapeutic approaches and targeted treatment strategies are currently undergoing clinical development. Due to the still limited evidence, patients should be included in clinical trials and recorded in registries.